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Thursday, February 19, 2015

Health Care Reform Articles - February 19, 2015

Greed, fear and other roadblocks to health care reform

By Dr. Philip Caper, Special to the BDN
Posted Feb. 19, 2015, at 10:38 a.m.
We often hear boasts about American exceptionalism. But there is at least one area where being exceptional is a negative.
Most other wealthy democracies have made health care a de facto right of all. Yet we have been arguing about whether to do so for nearly a hundred years and haven’t done it yet. We spend twice as much as other wealthy countries on health care, but still leave 15 percent of our people completely without health care coverage and many more vulnerable to illness-related financial hardship.
I recently helped organize a panel discussion at a conference in Washington, D.C., celebrating the 50th anniversary of Medicare and Medicaid, to examine why achieving health care as a right in America is so hard. The participants included world-class experts from academia, medical journalism, public service and advocacy groups. Here’s a summary of what emerged from our discussion. It’s not a very flattering picture of current American politics, culture and values regarding health care, but I think it’s accurate.
The barriers to reform these experts identified fall into four categories:
Apathy. Think of labor unions or corporate executives with tax-subsidized Cadillac plans. “I’ve got mine. Why should I worry about anybody else?” We pay dearly for such thinking. Or, think of the young and healthy who don’t believe they need health care and are willing to go without coverage despite the cost to others should they need care.
Fear, distrust and anger. Fear of change, not trusting that people are going to be better off if things change, no matter what that change is, especially if government is involved. Fear by doctors and other health care professionals that reform would be too effective in controlling health care costs, resulting in loss of profits and income.
Ideology and ignorance (not stupidity). Health care is complicated, and most Americans don’t understand the health care system or that there are better ways organize it. This includes doctors. We are trained to be experts in clinical medicine, not health care systems. Many Americans are unaware (ignorant) of the fact that wealthy countries have health care systems that are more popular than ours, produce superior results, include everybody and cost about half what we spend. It doesn’t occur to us that people in other countries don’t even think about money when illness or injury strikes. Many of us seem to subscribe to a unique ideology — rejected by most cultures — that health care must be “earned,” no matter how much or how little control a person has over their health status. Many are put off by the idea of accepting any government assistance, often known as “being on the “dole.”
Greed. This may seem harsh, but the evidence is piling up. The widely accepted view of health care as just another business is uniquely American, at least in degree. Some people view the health care system as a way to prevent, diagnose, treat and cure disease and assist in healing. Others view it as a business opportunity. These two differing views frequently are in conflict. The medical-industrial complex in the U.S. is an enormously profitable industry. Those putting profits above appropriate and effective health care would like to continue to be able to do so, and they use their wealth and the influence it buys in our corrupt political system to make sure they can.
Some believe the American health care system has become more of a wealth-extraction machine — from people who buy health care products and services to those who sell them — than a system concerned with health and well-being. This view is reinforced by recent news stories about the seemingly opportunistic and predatory pricing of critical medicines, nursing homes taking legal custody of elderly patients as a means of getting control of their bank accounts and aggressive collection tactics that include garnishing the wages of low-income workers, even by “nonprofit” hospitals.
A recent report by the charity Oxfam revealed that the health care and financial services industries are the largest contributors to increasing income and wealth inequality throughout the world.
These barriers to reform can and are being exploited by those with a financial or ideological interest in maintaining the status quo. If you wonder why health care reform in the U.S. is so difficult, just remember AFIG: apathy; fear, distrust and anger; ignorance and ideology; and greed.
To succeed in reforming our dysfunctional health care system, we must continue to motivate the apathetic, reassure the fearful, educate the ignorant and call out the greedy. We have a lot of work to do.

Brill's Bitter Pill: Accurate Diagnosis, Inadequate Treatment

by John Geyman, M.D.

Posted: 

Steven Brill, author of the well-known 2013 Special Report, Why Medical Bills Are Killing Us, in Timemagazine has just released his new book, America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System. (1) Based upon in-depth reporting of interviews with more than 240 people involved in various ways across our health care industry, he gives us an inside look at how the Affordable Care Act was written, passed, implemented and changed over the last five years. 
The result is an honest, damning indictment of our market-based system, with all its profiteering and run away costs. He concludes that the ACA, despite the hype of some of its architects and supporters, will fail to contain costs:
There's nothing in the legislation that brings down the cost of healthcare... The bad news is that the taxpayers are paying for it and they're paying the same exorbitant prices that make the system so unworkable... The drug companies are making more money, the hospitals are making more money, the medical device makers are making more money, and everybody is happy except the taxpayer. (2)
Brill's description of the flaws of our profit-driven system are further amplified by his own personal experience with open-heart surgery for an aortic aneurism. After an eight-day hospitalization, his medical bills came to $197,000. Some time later, even Stephen Hemsley, president and CEO of UnitedHealth Group, his health insurance company, could not explain the medical bills and explanation of benefits. 
Brill's meticulous and well-documented reporting of our system problems falls apart when it comes to fixing these problems. There is somehow a striking disconnect between his objectivity in the first part of the book and the proposals he puts forward toward the end. Yes, he is very well-informed, is a graduate of Yale Law School, and has had personal experience as a patient, but that does not make him a health policy expert, as many of his readers now expect. He says in his book, as he was recovering from surgery, he began to frame his "unusual idea" of how to go beyond the Affordable Care Act, which he believes is unsustainable because of costs, and to fix U.S. health care:
At first, pieces of it came in the form of seemingly random thoughts that popped up during the extra time I had to read and watch television. But they soon began to come together. (3)
These are the components of his seven-part proposal for regulating our health care system: 

    ‘The Patient Will See You Now,’ by Eric Topol

    By SANDEEP JAUHAR

    With his previous book, “The Creative Destruction of Medicine,” Eric Topol, a cardiologist and director of the Scripps Translational Science Institute, established himself as one of medicine’s most innovative thinkers about the digital future. In “The Patient Will See You Now,” his exhaustively researched follow-up, Topol turns his attention to medicine’s “democratization” via “unplugged digitization, with the smartphone as the hub.” With approximately two billion users worldwide, smartphones, Topol says, “are the most rapidly adopted technology in the history of man.”
    “We are about to see a medical revolution with little mobile devices,” he writes, and in this transformation, “smartphones will play a role well beyond a passive conduit.” They will perform blood tests, medical scans, and even parts of the physical examination. Topol calls this “bottom-up medicine,” in which digitally empowered patients will truly take charge of their own health care. Just as smartphones and social networks powered the uprisings of the Arab Spring, in Topol’s view they are now poised to bring democracy to medicine.
    The insurgency couldn’t happen soon enough. For too long, health care has been stymied by paternalistic restrictions on patient involvement. At some level this is because of information asymmetry: Doctors are privy to much more medical knowledge than their patients. Though Topol deems this a vestige of medicine’s ingrained authoritarianism, I rather believe it is a product of the inherent disparity in the doctor-patient relationship. Whatever the reason, it is hard to disagree when Topol, quoting an article in MIT Technology Review, argues that the patient is the “single most unused person in health care.”

    Enrollment Period for Health Insurance Ends; Now the Tax Penalties Start


    The Affordable Care Act’s second open enrollment period ended on Sunday. Well, almost. Some computer problems over the weekend have led the administration to give a one-week extension to people who tried and failed to sign up.
    But its tax penalty season has just begun. For people who didn’t sign up for coverage last year, and didn’t qualify for a special exemption, the consequences are starting to become clear. As people file their taxes, people who remained uninsured will be hit with penalties of either $95 or 1 percent of their income — whichever is higher. Those fines rise for people who don’t sign up this year, though they won’t feel the pain of that decision until next year.
    The tax penalties are a key feature of the law, devised as an extra encouragement for reluctant people to enroll in health insurance before they become sick. But awareness remains low among the uninsured, about both signup deadlines and the penalties.
    For those who know the trade-offs, the mismatch between the sign-up period and the penalty period doesn’t matter much. But for people who don’t understand how Obamacare works, unpleasant surprises are likely. Say you didn’t buy insurance last year, because you missed the deadline or you were unaware that subsidies would help make it affordable. You let this year’s enrollment period slide by for similar reasons. Only after it’s too late to sign up will you learn that you’ve been hit with a hefty fine for last year and will face a bigger one for next year.

    Employee or Contractor? Health Care Law Raises Stakes 

    By CONRAD DE AENLLE

    If you work for a living, do you know who your boss is? And if you run a business, do you know who’s on your payroll?
    These are simple questions. But you may not have the same answers as the Internal Revenue Service.
    The I.R.S. is emphasizing the distinction between employees and self-employed independent contractors this year, tax specialists warn. That makes it important for workers and critical for businesses that use their services to make sure to get the classification right. If you flub the answers, it could be costly.
    In a sense, this is a semantic exercise: If someone is doing a certain kind of work for a specific amount of pay, the label you put on it might not seem to matter much. But which is which and who is who helps determine the obligations that each party in the relationship has to the other and to the I.R.S.
    Contractors, being self-employed, are responsible for paying Social Security and Medicare taxes, and they are entitled to certain tax deductions for business expenses. If you’re an employee, though, you pay only half of these payroll taxes. Employers must cover the other half and now, if they’re big enough, health insurance under the Affordable Care Act.
    “We are expecting that there will be greater scrutiny by the I.R.S. of the independent contractor/employee distinction,” said Jeffrey Saviano, Americas director of indirect tax at Ernst & Young. “The stakes are higher for companies and the government because of the implementation of the A.C.A. and the employer mandate taking effect in 2015.”
    The law requires businesses with 50 or more full-time employees to provide them with health insurance that meets certain criteria deemed to make it affordable. Ian Shane, a tax lawyer at the New York firm Golenbock Eiseman Assor Bell & Peskoe, suggested that the desire to avoid the expense of providing coverage and the paperwork involved in demonstrating compliance provides an incentive for small businesses to find a way to classify some workers as contractors.

    Millions at risk of losing coverage as justices take up challenge to Obamacare

    Erin Meredith, a fifth-generation Republican who lives in Austin, was no fan of President Obama’s Affordable Care Act, which she considered just another wasteful government handout. She didn’t sign up for a health plan until late last year, when she felt she had no other choice. 
    By then, Meredith, who is 37 and has two children, had gotten divorced and lost the insurance provided through her husband. Her new job, as an office manager for a roofing company, didn’t offer benefits. About the same time, she learned that her headaches and fatigue were the result of a rare condition that affects the oxygen level in her blood. She couldn’t afford to spend thousands of dollars on doctor’s visits, and her desperation slowly turned to panic.
    In November, at a friend’s urging, Meredith looked for a health plan on the federal online marketplace. With an income of about $30,000 a year, she discovered she qualified for a government subsidy of $132 a month. Her premium would be $89 a month.
    Now that she has coverage, she doesn’t want to lose it. “I can still feed my kids and put gas in my car,” she said. “I’m not trying to go to Cancun or carry a Michael Kors bag. I drive a 2009 Mazda, and I’m just trying to make it in my little apartment and not be on government assistance.”
    Meredith is one of about 6 million people whose subsidized insurance hangs in the balance as the Supreme Court takes up a case that poses the most serious challenge to the Affordable Care Act since the court found the law constitutional more than two years ago.

    Maine among 6 states looking to keep ACA subsidies as Supreme Court eyes new challenge

    By David Morgan, Reuters
    Posted Feb. 17, 2015, at 6:19 a.m.
    WASHINGTON — Five Republican state governors say they will not rescue a crucial part of Obamacare if it is struck down by the Supreme Court, underlining the prospect for a chaotic aftermath to a ruling that could force millions of Americans to pay much more for coverage or lose their health insurance.
    The Supreme Court is due to hear opening arguments in the case known as King v. Burwell on March 4, marking the second major challenge to President Barack Obama’s Affordable Care Act after the justices ruled in 2012 against a claim that it was unconstitutional. The latest case tests the tax-credit subsidies at the core of Obamacare.
    In its ruling expected by June, the high court could bar the federally run insurance marketplace from providing the subsidies in at least 34 states. That could throw the insurance system into turmoil as states respond in starkly different ways.
    In response to Reuters’ queries, spokespeople for the Republican governors of Louisiana, Mississippi, Nebraska, South Carolina and Wisconsin said the states were not willing to create a local exchange to keep subsidies flowing. Republicans argue that Obamacare is unacceptable government intervention that raises costs for consumers and businesses.
    “State exchanges are the federal government’s way of sticking states with the cost and responsibility of a massive new bureaucratic program,” said Chaney Adams, a spokeswoman for South Carolina Governor Nikki Haley.
    “The right decision was made for South Carolina, and Governor Haley would make it again today.”
    State government officials in Georgia, Missouri, Montana and Tennessee — a mix of Republicans and Democrats — said that opposition by majority Republican state legislators could make it all but impossible to set up a new exchange.
    Those nine states combined are home to 1.4 million people who have signed up for subsidized coverage in 2015, according to government data. The fate of 5.1 million residents in the remaining 25 states that have signed up for subsidized benefits on the HealthCare.gov exchange is also unclear.
    Six states — Delaware, Maine, Ohio, Pennsylvania, South Dakota and Virginia — are discussing contingency plans to keep the subsidies but each faces substantial logistical or political barriers, according to officials.
    Ten states did not respond to Reuters queries, while three others had no comment. Iowa, Wyoming, Oklahoma and West Virginia said they were not currently considering setting up exchanges; Alaska said it has not ruled it out; and Arkansas said it was moving toward creating a state exchange in 2017.
    Republicans are opposed to Obamacare, but such a ruling could have a political cost in their states if hundreds of thousands of low-to-middle-income people are priced out of health coverage. Even if states say they don’t plan to set up exchanges, that could change closer to the ruling or afterwards as they come under pressure to avert spiraling insurance costs.
    “We can say with some confidence that the insurance markets are likely to melt down, because only the sick people will stay in them and the others will find it unaffordable,” said Drew Altman, who heads the non-partisan Kaiser Family Foundation.

    King calls for reprieve to help Mainers hit with Obamacare penalty

    by Jackie Farwell

    U.S. Sen. Angus King has asked the Obama administration to allow people hit with tax penalties for going without health insurance an extra opportunity to enroll.
    With tax season upon us, some Americans are coming face to face with Obamacare’s requirement that we all get health insurance. For the first time, tax filers must note their insurance status on this year’s returns. With few exceptions, those without coverage must pay a penalty.
    For 2014, the penalty amounts to either 1 percent of annual household income or $95 per adult/$47.50 per child, whichever amount is higher.
    It’s too late to avoid the penalty in 2014. But some taxpayers might think, “Well fine, Uncle Sam, I’d rather not fork this money over again next year, so I’ll sign up for insurance.”
    Not so fast. The window to enroll in a plan through Healthcare.gov for coverage in 2015 closed on Feb. 15. (It was already extended through Feb. 22 for people who started the enrollment process by the deadline but couldn’t finish due to technical issues. Some faced long wait times over the weekend as consumers raced to sign up.) Only people with special circumstances — such as a marriage, adoption or job loss — can sign up after that date, until the fall.

    Elimination of 'public option' threw consumers to the insurance wolves 

    Commentary: big firms and their campaign cash found a friend in Joe Lieberman 

    By 

    Democrats seek relief from health law penalties

    Some senior House members believe American deserve a second chance to sign up.
    BY RICARDO ALONSO-ZALDIVARTHE ASSOCIATED PRESS

    WASHINGTON — The official sign-up season for President Barack Obama’s health care law may be over, but leading congressional Democrats say millions of Americans facing new tax penalties deserve a second chance.
    Three senior House members strongly urged the administration Monday to grant a special sign-up opportunity for uninsured taxpayers who will be facing fines under the law for the first time this year.
    The three are Michigan’s Sander Levin, the ranking Democrat on the Ways and Means Committee, and Democratic Reps. Jim McDermott of Washington, and Lloyd Doggett of Texas. All worked to help steer Obama’s law through rancorous congressional debates from 2009-2010.
    The lawmakers say they are concerned that many of their constituents will find out about the penalties after it’s already too late for them to sign up for coverage, since open enrollment ended Sunday.
    That means they could wind up uninsured for another year, only to owe substantially higher fines in 2016. The fines are collected through the income tax system.
    “For the many families who may now be about to pay a penalty, there should be an opportunity to avoid both further penalties and to obtain affordable health insurance,” said Doggett.
    This year is the first time ordinary Americans will experience the complicated interactions between the health care law and taxes. Based on congressional analysis, tax preparation giant H&R Block says roughly 4 million uninsured people will pay penalties.
    The IRS has warned that health-care related issues will make its job harder this filing season and taxpayers should be prepared for long call-center hold times, particularly since the GOP-led Congress has been loath to approve more money for the agency.
    “Open enrollment period ended before many Americans filed their taxes,” the three lawmakers said in a statement. “Without a special enrollment period, many people (who will be paying fines) will not have another opportunity to get health coverage this year.
    “A special enrollment period will not only help many Americans avoid making an even larger payment next year, but, more importantly, it will help them gain quality health insurance for 2015,” the lawmakers added.
    So far, administration officials have deflected questions about whether an extension will be granted. Health and Human Services Secretary Sylvia M. Burwell has authority to grant special enrollment periods under certain circumstances.

    Doctors Strive to Do Less Harm by Inattentive Care

    By 

    Suffering. The very word made doctors uncomfortable. Medical journals avoided it, instructing authors to say that patients “ ‘have’ a disease or complications or side effects rather than ‘suffer’ or ‘suffer from’ them,” said Dr. Thomas H. Lee, the chief medical officer of Press Ganey, a company that surveys hospital patients.
    But now, reducing patient suffering — the kind caused not by disease but by medical care itself — has become a medical goal. The effort is driven partly by competition and partly by a realization that suffering, whether from long waits, inadequate explanations or feeling lost in the shuffle, is a real and pressing issue. It is as important, says Dr. Kenneth Sands, the chief quality officer at Harvard’s Beth Israel Deaconess Medical Center in Boston, as injuries, like medication errors or falls, or infections acquired in a hospital.
    The problem is how to measure it and what to do about it.
    Dr. Sands and his colleagues decided to start by asking their own patients what made them suffer.
    They found several categories. Communications — for example, a doctor blurting out, “Oh, it looks like you have cancer.” Or losing a valuable, like a wedding ring. Or loss of privacy — a doctor discussing a patient’s medical condition where an adjacent patient could hear.
    “These are harms,” Dr. Sands said. “They elicit suffering. They can be long lasting, and they currently are largely unquantified, uncounted, unrecorded.”
    One way to quantify these harms is to observe and note them, which is part of what Beth Israel Deaconess is doing. Another is to supplement efforts with patient surveys. Patient surveys, of course, have been around for decades. And since 2007, Medicare has required short surveys after discharge.

    Americans May See Appeal of Medical Tourism in Cuba

    By 

    HAVANA — Anuja Agrawal jumped on the phone. President Obama had just announced that he would restore diplomatic relations with Cuba — and Ms. Agrawal, who runs a medical tourism company in Orlando, Fla., did not want to miss her opening.
    She reached a health care administrator in Cuba, agreeing to move ahead with a deal that they had been discussing for months in the hope that American patients could soon start traveling to the island for medical treatment.
    “There was a lot of excitement about it,” said Ms. Agrawal, the chief executive of Health Flights Solutions, adding that if Americans start traveling to Cuba for affordable medical treatments, it could mean a big economic boost for the country’s health system. “For them, they’re looking at it literally like winning the lottery.”
    As the Obama administration chips away at the economic isolation of Cuba, whittling at an embargo that is older than most people on this island, industries of many kinds are trying to figure out what the easing of tension will mean for them, and exactly how much wiggle room there will be.
    Thousands of people from other countries go to Cuba each year for what is known as medical tourism: travel abroad for surgery or other medical care, often because the treatment is less expensive there or is not available where patients live.

    Health care unaffordable

    The Bangor Daily News has been very supportive of the Affordable Care Act or Obamacare. A number of success stories of people having health insurance because of ACA have been in feature stories and editorials. I understand that in a poor state like Maine.
    What troubles me is the lack of effort by this paper and our leaders to go after health care cost. I recently had a cortisone shot for a shoulder issue and the invoice was $600. This took less than 10 minutes with a physician and an ultrasound machine.
    While our president, senators and representatives are pointing figures at each other, the healthcare industry is in a feeding frenzy making money hand over fist. I’m sure the shareholders of Anthem made a lot more on their investment than I did with mine at local credit union. I’m also sure they paid less income tax on those gains.
    Shouldn’t anyone be able to afford to have a simple medical procedure done without “insurance”? I’m a lifelong conservative, but think the time is here for a single-payer system. Free enterprise or not, there is something fundamentally wrong with making that much money through someone else’s pain.
    Richard Ginn
    Bucksport

    The Health Law, in the Real World


    To the Editor:
    As Elisabeth Rosenthal eloquently documents in “Insured, but Not Covered” (news analysis, Sunday Review, Feb. 8), our health insurance system is little better than the nonsystem we had before the Affordable Care Act.
    President Obama’s reform was doomed by the failure to exclude the major profit-driven industries (health insurance, drug manufacturers and for-profit, hospital-based medical-industrial corporations) from taking it over and milking it for profits.
    Virtually all of the problems (excluding the initial enrollment difficulties) can be attributed to tactics intended to transfer more cost to the consumer (and the government, which is ultimately us), while delivering higher profits for less actual care, which we are discouraged from seeking.
    Congressional Republicans propose to turn even more of the system over to private, for-profit entities; instead, we should be instituting “improved Medicare for all.” Covering everyone equally, and eliminating time- and money-consuming confusion with a clearly defined, dependable system, relatively simple to understand and administer, would save billions of dollars while providing better care.
    NANCY T. BLOCK
    Berkeley Heights, N.J.
    The writer is a psychiatrist.
    To the Editor:
    The news analysis by Elisabeth Rosenthal is a good examination of the Affordable Care Act and its effect on many Americans. I can relate, as I watched my monthly premium go to $539 a month from $285 and my yearly deductible to $3,500 from $2,500.
    True, the health law brought coverage to many in need, but it has also created a mess for many of us. Rather than rail against the entire law and call for its repeal no matter what, reasonable people need to talk across the aisle and take a cold, hard look at how to provide the coverage that is needed.
    The stories told in the news analysis are not outliers: I am hearing similar tales from people I know.
    Being disappointed in the Affordable Care Act is not a partisan issue.
    DORALEE HALPERIN
    Washington
    To the Editor:
    The new health care marketplace requires that all who use it transform themselves into savvy consumers who must master complex regulations about costs from one company and one plan to another, and constantly keep abreast of ever-changing narrow networks.
    This is difficult enough for healthy people, but for someone with a chronic, complex or debilitating illness, transforming oneself into a professional shopper becomes an impossible task. Such people may be unable to continue treatment with doctors who know them and who have come to understand their particular condition over time.

    When One Penalty Is Enough

    By 

    Millions of Americans may be in for a shock when they file tax returns and learn that they have to pay a fine for failing to enroll in health insurance in 2014 and an even bigger fine for failing to enroll in 2015 before the enrollment period ended on Feb. 15. While there is nothing they can do to avoid the 2014 fine, which must be paid this year, they could avoid the 2015 fine, payable next year, if the Obama administration allowed them more time to enroll.
    The government should open a special enrollment period that lasts beyond April 15, the traditional filing time for most taxpayers. That would be fair to millions of consumers who remain uninformed about the health care law and ignorant about the subsidies it provides and the penalties for failing to enroll. And it would strengthen implementation of health care reform.
    The Affordable Care Act requires most Americans to obtain health insurance or, with some exceptions, pay a fine, which is assessed at the time they pay their income taxes. For individual adults who failed to enroll in 2014, the fine is $95 or 1 percent of applicable yearly income, whichever is higher. For individuals who failed to enroll in 2015, the fine will jump to $325 or 2 percent of applicable yearly income, to be paid when taxes are filed next year. That is a big jump that will hurt many people on modest incomes. The fines leap even higher the following year.



    Maine Senator Seeks Second Chance for Those Facing Health Care Penalty 

    By 

    WASHINGTON - Some Maine tax filers may discover they're taking a hit this year for failing to sign up for health insurance in 2014. It's the first year that consumers are held accountable to the Affordable Care Act's individual mandate.
    And if the uninsured want to avoid getting hit with another, steeper penalty next year? It's too late - because open enrollment for 2015 coverage closed Sunday. Maine independent Sen. Angus King wants to change that. He's one of several members of Congress who are urging the Obama administration to create a special enrollment period to give consumers a second chance.
    It's still early as far as tax filing season goes, so Leslie Poake of Bangor accounting firm Loiselle Goodwin and Hinds says she's only seen a trickle of tax returns in which a client owes a penalty for not signing up for insurance. But she expects to see more, and she doesn't relish being the messenger.
    "People aren't coming to their accountant expecting that we're going to be suddenly enforcing health insurance laws," she says. "While that's not really what we're doing, we are calculating a penalty in some cases and putting it on their tax return, and then we're in the position to have to explain that penalty to them."
    A statewide coalition that offers free tax help - CA$H Maine - sought to soften the blow by staffing its clinics with enrollment specialists to help people sign up for insurance to avoid a penalty next year.

    Maine CDC Whistle-Blower to Get $142,500 From State 

    By  
    AUGUSTA, Maine — The settlement announced last month in a whistle-blower case targeting the Maine Center for Disease Control calls for a former employee to receive $142,500.
    The Sun Journal reported that the Maine Department of Health and Human Services will pay to settle a federal whistle-blower claim by Sharon Leahy-Lind. A second plaintiff, Katie Woodbury, will receive $22,500. Their lawyer, Cynthia Dill, will be paid $85,000 for legal fees.
    Leahy-Lind, a former director of the division of local health, says she was retaliated against for refusing to shred public documents related to a grant program. Woodbury, a current CDC office manager, joined the lawsuit.
    Their lawsuit sought compensation, punitive damages, legal fees and a declaration that they acted lawfully. As part of the agreement, DHHS did not admit any wrongdoing.

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